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Organization

GAYLORD OPCO, LLC

Active
Other names
Medilodge of Gaylord
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STACEY PAUL ROGERS (CHIEF FINANCIAL OFFICER)
(502) 429-8062
Entity
Organization

Contact information

Practice address
508 RANDOM LN, GAYLORD, MI 49735-9304
(989) 732-3508
Mailing address
7400 NEW LA GRANGE RD STE 100, LOUISVILLE, KY 40222-4870
(502) 429-8062
(502) 429-0650

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Enumeration date
08/17/2017
Last updated
07/21/2022
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